To listen to the live Broadcast, please see below. Maine holds the dubious distinction of having more people seeking treatment for opiate addiction than any other state in the country. Historically, policy makers have sought to address the problem by increasing penalties for drug crimes. And they've passed legislation to get doctors to keep track of prescriptions. But that program is voluntary. Now, a Portland lawmaker has introduced a bill to establish protocols around the prescription of drugs to treat chronic, non-cancer pain.Maine has long held the record for the number of people being admitted for treatment of opiate addiction. And Democratic Rep. Jon Hinck, of Portland, says the statistics for opiate treatment admissions have only gotten worse.
"In 1998, we were leading the country already with 28 for every 100,000 people--the national average was nine for every 100,000 people," Hinck says. "Now, in the most recent statistics, Maine has 386 admissions for every 100,000 people and the nation is 45. Our problem is far, far worse than even the national average."
As an attorney who filed one of many lawsuits against Oxycontin manufacturer Purdue Pharma 10 years ago over its marketing of the drug, Hinck says he's been concerned that Maine hasn't made enough progress in combating opiate abuse, diversion and addiction. He sponsored a bill a few years ago to create a prescription monitoring program in Maine. But that program remains voluntary with fewer than half of the state's health care providers participating.
This year, Hinck is trying a different tack.
He's introduced LD 1501, "An Act to Reduce Opioid Overprescription, Overuse and Abuse," with the idea of establishing best practices for certain health care providers who prescribe pain medication. He sees it as a way to help prevent so-called "doctor shopping" by addicts.
"One of the first things a doctor would have to do is a thorough assessment of what other providers the patient is seeing and also check with the pharmacy to make sure that there aren't multiple prescriptions coming in for the same patients," he says.The bill does not affect doctors treating patients for acute pain in the emergency room or cancer pain. But for chronic, non-cancer pain it does require patients to consent to urine screens, and it requires physicians to keep better records and do more follow up. "When I lecture on pain and addiction around the state, essentially those are the elements that I teach," says Dr. Mark Publicker, an addiction specialist at the Mercy Recovery Center in Westbrook. "Simple things: Perform a physical examination, take a good history, understand psycho-social issues, develop a treatment plan with the patient and periodically review it. And all of these things are perfectly reasonable and would result in better medical practice."
Hinck's bill has several co-sponsors from both parties. And it also makes sense to Raymond Johnson, an addict in recovery at Portland's Serenity House. He says he started abusing opiates at the age of 15 after adult friends and relatives sold him their medication. He says his friends would find doctors willing to prescribe for pain that didn't exist.
"I know people that were getting prescriptions written to them for over 340 Roxy 30s a month, and then on top of it they'd get another 300 and something Roxy 15s a month," he says.
Johnson admits he also doctor shopped and faked injuries in the emergency room in order to get prescribed the drugs he wanted. But Rep. Hinck, Dr. Publicker and Gordon Smith of the Maine Medical Association say doctors can't be blamed for a prescription abuse and diversion problem that is multi-faceted and firmly entrenched.
Smith says there are many aspects of Hinck's bill that his members will support. "The provisions of the bill that really micro-manage the practice is going to be a problem because it's going to hurt people that actually need pain medication. All of this, you're seeking a balance, and the more that you balance it towards restrictions on how you can prescribe and who you can prescribe to, the more people actually are in real pain, they're going to have a more difficult time getting it."
The director of the Maine Office of Substance Abuse says he is still evaluating the legislation and has not taken a position on it. A hearing on the bill is scheduled for next week.
Source:
The Maine Public Broadcasting Network
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